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General NPI Number Information
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NPI Number | 1326170499
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Entity Type | Individual
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Provider Name | NICHOLAS JAMES VETTER L.M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 11565 LAUREL CANYON BLVD STE 101
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City | SAN FERNANDO
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State | CA
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Zip | 91340-4649
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Country | US
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Telephone | 818-838-1352
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Fax | 818-838-1362
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Provider Business Mailing Address
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Address Line | 17508 NORDHOFF ST
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City | NORTHRIDGE
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State | CA
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Zip | 91325-2903
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Country | US
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Telephone | 818-838-0779
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Fax | 818-886-5664
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 48867
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License Number State | CA
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